engleski

The Study of Statins Consumption in Croatia

INTRODUCTION The normalization of blood lipid profile has become an accepted therapeutic measure of primary and secondary prevention of vascular disease, with statins being the most popular group of medicines prescribed to lower cholesterol and LDL cholesterol levels. Statins are the HMC-CoA reductase inhibitors and the most important group of lipid modifying agents (ATC C10). In order to obtain the general insight of statins consumption trend in Croatia, the study of consumption in urban and rural surroundings in the period from 2004 to 2006 was performed. Consumption data were compared with data for these drugs in Norway, Finland and Denmark for the same period (2004-2006). MATERIAL AND METHODS The statins consumption data were retrieved from the Croatian Agency for Medicinal Products and Medical Devices (ALMP) database. The data were extracted from annual reports to ALMP for 2004, 2005 and 2006 year and were collected from 44 pharmacies in total, out of which 22 were from urban and 22 from rural surroundings. The statins consumption is expressed in number of DDD/1000 inhabitants/day (DDD – Defined daily dose). The estimation of DDD/1000 inhabitants/day was made on the basis of issued/sold packages of each statin using the following expression: DDD x 1000/population x 365. The consumption of simvastatin, atorvastatin, fluvastatin, pravastatin and lovastatin were analyzed using Farmakoekonomika – MaPIS software (Mapro d.o.o. Croatia). RESULTS AND DISCUSSION The results of the study showed an increase in overall consumption of lipid modifying agents (ATC C10) in the period from 2004 to 2006. In total issued drugs (DDD/1000 inhabitants/day) in 2004, 2005 and 2006, the lipid modifying agents (ATC C10) were represented with 28.13, 36.03 and 46.21 DDD/1000 inhabitants/day or 4.27, 5.26 and 6.64%, respectively. (Table 1). Of five statins (Table 2) issued in that period the most issued/prescribed, in both urban and rural surroundings were simvastatin and atorvastatin ( 90%). The comparison of these two, the most prescribed statins, atorvastatin and simvastatin (in DDD/1000 inhabitants/day) showed a significant increase in atorvastatin consumption from 2004 to 2006. (Table 3) The consumption of atorvastatin significantly exceeded simvastatin consumption in 2006 (Fig. 1). The comparative analysis of simvastatin and atorvastatin consumption in Croatia (2004 to 2006) with consumptions in Norway, Denmark and Finland were performed. (Table 4, Fig. 2 and Table 5, Fig. 3) The results of analysis showed that consumptions of both, simvastatin and atorvastatin, were significantly lesser in Croatia than in European countries. CONCLUSION The consumption trend of lipid modifying agents (ATC C10) in Croatia is in permanent increase, and especially of statins. The most significant consumption in the investigated period (2004 to 2006) was obtained for simvastatin and atorvastatin. The results of this study indicate on different degree of statins consumptions in different part of Croatia, and these differences are especially significant between urban and rural surroundings. The comparison of simvastatin and atorvastatin consumptions data for Croatia with those in Norway, Denmark and Finland showed that consumption in Croatia was significantly lesser than in other countries, and that the consumption vary from country to country. Additionally, more data are necessary for final concludings of this research, including results of forthcoming study for the same medicines in the period from 2007 to 2009. References 1. Reiner Ž, Statins in primary and secondary prevention of coronary diseases, Medicus. 2003 ; 12: 85-90. 2. Vaughan CJ, Gotto AM, Update on statins.2004 ; 110:886-892. 3. Wertheimer AI, Santella TM, Problems using the defined daily dose (DDD) as a statistical basis for drug pricing and reimbursement, International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), 2007.

Statins; lipid modifying agents; drug consumption; defined daily dose; DDD; simvastatin; atorvastatin; paravastatin; fluvastatin; lovastatin

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